| R Wesley Lauderback Dds Pllc | |
|
222 Headtown Rd Jonesborough TN 37659-5073 | |
| (423) 753-9191 | |
| Not Available |
| Full Name | R Wesley Lauderback Dds Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 222 Headtown Rd, Jonesborough, Tennessee |
| Authorized Official Name and Position | Richard W Lauderback (OWNER/DENTIST) |
| Authorized Official Contact | 4237410120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| R Wesley Lauderback Dds Pllc 222 Headtown Rd Jonesborough TN 37659-5073 Ph: (423) 741-0120 | R Wesley Lauderback Dds Pllc 222 Headtown Rd Jonesborough TN 37659-5073 Ph: (423) 753-9191 |
| NPI Number | 1679216576 |
|---|---|
| Provider Enumeration Date | 04/18/2022 |
| Last Update Date | 04/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679216576 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |